Coronary artery pressure and flow analysis

Dr Sukhjinder Nijjer is a Specialist Registrar in Cardiology and a
MRC Clinical Research Fellow undertaking a PhD at the International Centre for Circulatory
Health.

His research integrates invasive and non-invasive coronary artery pressure and flow analysis
to better understand how blood flow in the coronary arteries is affected by blockages and
heart valve conditions.

Chest pain and breathlessness are common in patients with blocked coronary arteries and is
commonly treated with stents. Choosing when and where to put the stents can be difficult
and Cardiologists often rely upon experience and judgment. Sukhjinder is using a
combination of invasive pressure and flow information together with three dimensional
reconstructions of coronary arteries to help Cardiologists identify where best to place stents.

In some cases, patients with normal coronary arteries have symptoms of chest pain.
This is common in patients with aortic stenosis, where a narrowed heart valve places
strain on heart function. Only a heart operation will help but knowing when to do the
operation requires balancing risks of surgery and the risks of heart damage. Using wave
intensity analysis it is possible to detect the early changes that indicate a reduction
in blood flow before the heart muscle is damaged. To make this really useful for patients,
Sukhjinder is developing a non-invasive to assess when patients with aortic stenosis have a
reduction in their blood supply and so help identify those patients who need to undergo heart
valve surgery before heart damage occurs.

‘Knowing how coronary blood flow is affected by different types of
disease will help us treat patients more precisely. The aim is develop systems and tests that
are simple to use, reliable and genuinely helpful to both patients and clinicians in clinical
practice’.